Clinical hypnosis: Something for you?
By Olafur S. Palsson, Psy.D.

You sit comfortably reclined in an easy chair in a softly lit office. As you listen to your therapist with your eyes closed, you find your body relaxing more and more. Guided by the calm and confident voice, you allow your mind to let go and turn inward. You drowsily notice a mildly curious floating sensation in your body, as if you are not really sitting in the chair anymore, but rather floating - in the air, or in water. The voice talking to you gradually becomes more distant, and you even find yourself forgetting that it is there... but somehow the soothing voice continues to affect you, gently and almost automatically. As you relax even further, your awareness of where you are, why you are there, and who is speaking to you, recedes into the back of your mind. You just content yourself with effortlessly allowing the voice to act on you, and with enjoying this state of profound relaxation and deep calm... You are having a typical hypnotic experience.

THE ENIGMA OF HYPNOSIS
Hypnosis is one of the most intriguing phenomena in our mental functioning. It is full of seeming paradoxes: It is definitely not sleep, and yet is not really a waking state either; it depends on attention and concentration, and still is most often characterized by letting go and relaxing; it is most easily induced by a skilled person using specific verbal techniques, and yet it is exclusively the product of the hypnotized person's own mental abilities. Hypnosis has been extensively investigated in a scientific manner over a period of sixty years - and yet no generally accepted definition of the phenomenon exists. Fortunately, though, there is agreement among researchers and practitioners about what typically occurs when a person experiences the hypnotic state, and how the hypnotic state can be used to help people with a variety of problems.

WHAT REALLY HAPPENS UNDER HYPNOSIS
Hypnosis involves, more than anything else, changes in a person's attention and concentration. The focus of attention is narrowed, and the things attended to are experienced more intensely than in the ordinary waking state. Hypnosis has therefore been likened to turning out the lights in a windowless room and looking around with a flashlight. What you focus on holds your entire attention under hypnosis, so you tend to experience whatever you think of, imagine or remember, more vividly and clearly than you ordinarily can. At the same time, things which are outside the narrow focus of enhanced attention at any given time may be forgotten. For this reason, people sometimes temporarily become disoriented under hypnosis: Their awareness of where they are, the reality of their life situation, and even occasionally, exactly who they are, becomes clouded.

Another characteristic of the hypnotic state is a subjective sense of "involuntariness". People often state that under hypnosis they feel like passive observers to whatever takes place. For example, if you are asked under hypnosis to raise your hand, you may feel your hand rising like a robot arm, without any conscious doing or even decision on your part. This automaticity is by some considered the hallmark of true hypnotic experience. This is not really helpless involuntariness, however. Experience shows that if you really need to or want to, you can resist any direct suggestion on part of the hypnotist. You can even wake yourself from of the hypnotic state if you really want to.

People typically experience both mental tranquility and physical relaxation under hypnosis (relaxation is not a necessary condition for hypnosis, however; one can be both mentally and physically tense, and still be in a state of deep hypnosis). Various changes in perception are also common under hypnosis. Some people feel great heaviness coming over their bodies, others feel very light, numb or even disembodied. Subjective floating, sinking, spinning, and tingling sensations are often reported.

Other changes that accompany the hypnotic state, are the ones which make hypnosis a remarkable tool for mental and physical healing and make the various specialized hypnotic techniques possible. For example, hypnotic analgesia, the blocking of pain with the aid of hypnosis, depends on the mind´s ability to alter body perception in response to suggestion under hypnosis. Age regression, where the person´s mind recreates past experiences in vivid detail as if the events are being relived, relies on the greatly facilitated access to remote memory. Automatic writing, where the subject´s arm is temporarily disengaged from consciousness and allowed to write out responses reflecting unconscious material, depends on the mind's passive automaticity; and projective techniques, such as watching something revealing about your problem on an imagined TV screen, make use of the enhanced creativity and imaginative ability possible under hypnosis. Finally, posthypnotic suggestions, which are instructions given to people under hypnosis that affect them after they wake up, rely on the increased automatic receptivity to suggestions in the hypnotic state.

HYPNOSIS AS A HELPING TOOL
Hypnosis has countless uses in psychotherapy, psychiatry and various medical specialties. The use of hypnotic techniques by the helping professions has increased steadily in recent years, because hypnosis is gaining widespread acceptance as a safe, reliable, effective and comfortable alternative or adjunct to other, more traditional methods. In the modern climate of skyrocketing health care costs, hypnosis is also proving invaluable as an aid in speeding recovery from physical and mental problems.

Clinical hypnosis is, however, by no means a new healing tool. The first uses of hypnosis by health professionals occurred more than two hundred years ago. In its early days, clinical hypnosis was used to treat hysterical conditions, and was also very useful for the induction of anesthesia in surgery in the days before anesthetic drugs. For example, James Esdaile, a Scottish physician working in India in the early part of 19th century performed over three hundred and forty major operations, including amputations and removal of large tumors, with hypnosis as the only anesthetic. Around the turn of the 20th century, Sigmund Freud used hypnosis extensively in the first years of his psychicatric practice, but abandoned it in favor of psychoanalysis, a slower but more meticulous method of mental healing. In the first half of the 20th century, hypnosis was often viewed as an exotic or fringe method in medicine and psychology, but slowly gained respect as a potent clinical tool. It finally earned formal recognition as a valuable tool in health care in 1958, when the Council on Mental Health of the American Medical Association recommended that instruction in hypnosis be included in medical school curricula. Hypnosis was similarily embraced several years later by the American Psychological Association. Thousands of psychologists, dentists, and physicians in various specialties now have thorough training in hypnotic methods within their specialty areas. Professional organizations in clinical hypnosis provide extensive training and continuing education in hypnosis, and provide their members with specific ethical guidelines for the professional use of hypnosis.

WHAT HYPNOSIS CAN DO FOR YOU
There are many good reasons to seek the services of medical professionals or psychotherapists skilled in the use of hypnosis. In psychotherapy, hypnotic techniques are effective in speeding the process of therapy. Hypnosis is used effectively to facilitate patients' understanding of themselves or their problems, extinguish unfortunate habits, uncover repressed or forgotten memories, reduce anxiety and fears, and develop a new and more adaptive outlook. In medicine and health psychology, hypnosis is used to effectively treat irritable bowel syndrome, reduce pain and discomfort associated with medical procedures such as childbirth, treatment of burns, and surgery where anesthesia cannot be used effectively. It is also used to treat chronic pain and psychosomatic problems and counter unhealthy habits that contribute to illness. In dentistry, hypnotic analgesia is an effective needleless alternative to topical anaesthetic drugs, reduces bleeding and discomfort in oral surgery, and is used to treat teeth grinding and temporomandibular joint (TMJ) syndrome.

WHAT TO EXPECT
Many people feel somewhat apprehensive and have numerous questions when they consider the possibility of seeking clinical hypnosis for their problems. The following are answers to some of the most common questions and concerns people voice about hypnosis:

How does it feel to be hypnotized? There is really no such thing as a specific hypnotized feeling. As described earlier, a number of different experiences are commonly associated with the hypnotic state. The most unique characteristic, the one that people tend to remember best and find most surprising, is perhaps the subjective sense of "involuntariness" - of things happening without you (seemingly) acting to make them happen.

Will I lose consciousness? As mentioned above, hypnosis is not sleep. Ordinarily, you will be conscious of everything that goes on when you are in the hypnotic state. Sometimes, though, you may relax so much under hypnosis that you may drift off and lose track of what is happening, - or even fall asleep !

Will I reveal deep secrets about myself? In some psychotherapeutic applications of hypnosis, it is important to uncover mental material that is related to the problem being treated, - material which you have been ignoring or keeping secret from others and even from yourself. However, no such uncovering is needed in many applications of clinical hypnosis (especially in medical and dental hypnosis - in the treatment of IBS with hypnosis no such uncovering is necessary). If you are very uneasy about the possibility of introspective exploration of this kind, you should discuss it with your hypnotist in the beginning of your work together. Uncovering techniques may not be needed at all to deal with your problem. Hypnosis can be used in many different ways.

Will I do something embarrassing or silly? A clinical hypnotist will not make you cluck like a chicken or do other things for amusement at your expense. You do, however, sometimes act differently under hypnosis than you do in the normal waking state. You may become more emotional or feel more childlike. If the process involves uncovering of past experiences, these might also feel embarrassing or uncomfortable. Your therapist is used to such things, however, so there is no need to feel embarrassed. And generally, the benefits of the hypnotic intervention will by far outweigh the slight discomfort on your part from any deviation from prim and proper behavior which might occur.

What if I do not want to lose control of myself? Hypnosis does involve a certain amount of letting go of yourself and opening up to a new experience. However, you are not really losing control of yourself when you respond to what the hypnotist suggests. You are making the decision to go along with his or her guidance at every step. You can benefit from hypnosis as long as you are willing to go along with the instructions of hypnotist. It may be helpful to think of the hypnotist as your personal coach - a person helping you to master new ways to use your own mind.

What if I do not wake up again? Not to worry. Only in movies and bad novels do people get stuck in the hypnotic state. In the real world, it happens only very rarely that people cannot be immediately brought back into the ordinary waking state at the end of a hypnosis session. When that happens, it may simply take them a little longer to come to, or they slip into ordinary sleep and have a nap, and then wake up. In either case, there is no reason for concern.

Can I be made to do things I do not want to do? Contrary to a popular belief, people under hypnosis are not captive and spellbound. They can resist direct instructions that are at odds with their wishes or moral standards. For this reason, it is not as easy as one might think to make people do things against their will with hypnosis. Unfortunately, however, it has been adequately demonstrated, both in experiments and in established rare cases of misconduct, that hypnosis can be deliberately misused by a skilled hypnotist through the use of sophisticated deception. This is the most important reason for seeking a reputable professional whom you feel comfortable as your hypnotist. If you begin to feel uncomfortable with the person you have selected, talk about it. And if you feel you cannot do so, remember that you are the customer and you are always free to leave without making any apologies.

What if I cannot be hypnotized? The odds are against it. While the degree to which people are receptive to hypnosis varies from individual to individual, the great majority of people, perhaps three out of every four individuals, can be hypnotized to a sufficient degree to enjoy some of the benefits that hypnosis can offer.

Aren't gullible or simple-minded people most easily hypnotizable? Not at all. In fact, researchers have found that more intelligent people are slightly more hypnotizable. It seems that openness to new experiences, rather than gullability, is related to hypnotic ability.

Are women more hypnotizable than men? Research has conclusively shown that, on the average, there is no difference between men and women in their susceptibility to hypnosis.

Can hypnosis be dangerous to my mental health? The state of hypnosis is generally very safe and free from complications - probably no more disturbing to your mind than ordinary sleep. However, in rare cases, people who suffer from mental problems to such degree that they are struggling with their grip on reality may get worse due to the disorientation which is a part of hypnotic experience. Also, hypnosis involves enhanced contact with unconscious material. Individuals hiding something very uncomfortable or traumatic from themselves may therefore occasionally feel agitated after hypnosis as a result of coming too close to their secrets under hypnosis. This is an important reason for choosing only a well trained and competent clinical hypnotist who would be able to help you deal with such effects. For most people, however, the experience of hypnosis is pleasantly relaxing and refreshing. The only aftereffects you are likely to experience are possible drowsiness and disorientation for the first few minutes afterwards, and possibly stiff neck or (rarely) a minor headache. All these side effects are transient and harmless.

Can people hypnotize themselves? Yes, they can. Entering hypnosis is simply a mental skill, and hypnotherapists commonly believe that regular hypnosis is nothing more than assisted self-hypnosis. It is just more easily learned under the guidance of a skilled hypnotist. However, once you have mastered it, you can do it on your own. This is the goal in many applications of clinical hypnosis, such as for pain control, where the benefits of hypnosis need to be available at any time.

HOW TO FIND A QUALIFIED HYPNOTIST
Hypnosis is kind of like an empty syringe. Anybody can stick a needle into your body, and similarily, anybody can learn, in the space of half an hour, to induce a hypnotic state in another person. Hypnosis in itself, though, does not help people with physical or psychological problems, anymore than sticking them with a hypodermic needle does. The benefits of hypnosis depend almost entirely on what is done after the hypnotic state has been induced (that is, what is put into the "syringe"), and this is what requires professional skill and specialized knowledge and training. Hypnosis has many non-clinical uses. It can be of use in improving your golf game, helping you relax, or enhancing your creativity. If you are seeking psychotherapeutic or medical benefits from hypnosis, however, it is important to choose your hypnotist carefully.

Hypnosis is not restricted or regulated by law in many states in the U.S. This is a cause for great concern to many health professionals who use hypnosis. It means that any kind of person, regardless of education, training or experience can, and does, offer you hypnosis services. Hypnosis is sometimes misused, either deliberately or, more often, due to incompetence. It is essential that you take care to find a properly qualified and educated professional to conduct medical or psychological hypnosis. A self-proclaimed "hypnotherapist", often found through the yellow pages, may not have any formal education in mental health or psychotherapy. A "professional hypnotist", by the same token, means nothing more than a person who hypnotizes people for money. Furthermore, most hypnosis certificates and vanity titles such as C. Ht. ("certified hypnotherapist") have little or no bearing on the quality of a hypnotist or give indications of his or her qualifications to treat health problems.. There are two good guidelines for finding a qualified clinical hypnotist:

1. The only people qualified to treat your mental or physical problems with hypnosis, are those who are also qualified to treat the same problems without hypnosis. Therefore you need to look for proper and accepted clinical degrees, specialties in the particular area relevant to your problem. More importantly, find out whether the person is a state-licensed health professional. This is important because each state regulated who is qualified through education and training to practice each area of clinical work. The only exception to this is if you are referred directly by a clinician to a hypnotherapist for a specific purpose.

2. Look for a person who is a member of one of the two reputable national organizations of professionals in clinical hypnosis. These are the American Society for Clinical Hypnosis and the Society for Clinical and Experimental Hypnosis (ASCH). Both organizations restrict their membership to qualified and properly licensed professionals, provide training of high quality, and require their members to adhere to ethics codes that dictate proper uses of clinical hypnosis. You can write to ASCH (enclosing a stamped, self-addressed envelope) and get a list to practicing members of the society in your area. Their address is:

The American Society of Clinical Hypnosis
140 N. Bloomingdale Rd.
Bloomingdale, IL 60108-1017
email: info@asch.net